To the Editor: In our 3 published
literature reviews on the sexual abuse of boys,1- 3 we
documented, and then avoided, methodological shortcomings of previous
reviews. Drs Holmes and Slap,4 however, repeated these
shortcomings, thereby compromising the value of their review.
First, in examining "sequelae," they relied too heavily on clinical
samples, which are highly atypical and do not generalize, as we have
shown both narratively1 and statistically2- 3 in
our reviews of the nonclinical literature. In 2 meta-analyses, one on
national samples and another on college samples, we found that the
sexual abuse–adjustment association for boys is small
(r=0.07). By contrast, associations in
clinical samples are frequently medium to large. Holmes and Slap paid
inadequate attention to clinical vs nonclinical distinctions and
generalizability issues.